scholarly journals Effect of Early Enteral Nutrition on Clinical Outcomes in an Intensive Care Unit

Thrita ◽  
2014 ◽  
Vol 3 (3) ◽  
Author(s):  
Sima Ghorabi ◽  
Zahra Vahdat Shariatpanahi
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Clinical Outcomes ◽  
Early Enteral Nutrition

The Benefits of Parenteral Nutrition (PN) Versus Enteral Nutrition (EN) Among Adult Critically Ill Patients: What is the Evidence? A Literature Review

2019 ◽  
Vol 35 (7) ◽  
pp. 615-626 ◽  
Author(s):  
Angel Joel Cadena ◽  
Sara Habib ◽  
Fred Rincon ◽  
Stephanie Dobak
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Parenteral Nutrition ◽  
Clinical Outcomes ◽  
Critically Ill ◽  
Nutrition Support ◽  
Mechanical Ventilation Duration ◽  
The Impact

Malnutrition is frequently seen among patients in the intensive care unit. Evidence shows that optimal nutritional support can lead to better clinical outcomes. Recent clinical trials debate over the efficacy of enteral nutrition (EN) over parenteral nutrition (PN). Multiple trials have studied the impact of EN versus PN in terms of health-care cost and clinical outcomes (including functional status, cost, infectious complications, mortality risk, length of hospital and intensive care unit stay, and mechanical ventilation duration). The aim of this review is to address the question: In critically ill adult patients requiring nutrition support, does EN compared to PN favorably impact clinical outcomes and health-care costs?

Early Enteral Nutrition in Geriatric Burn Patients: Is There a Benefit?

2020 ◽  
Vol 41 (5) ◽  
pp. 986-991
Author(s):  
Lourdes Castanon ◽  
Samer Asmar ◽  
Letitia Bible ◽  
Mohamad Chehab ◽  
Michael Ditillo ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Length Of Stay ◽  
Enteral Nutrition ◽  
Early Enteral Nutrition ◽  
Burn Patients ◽  
Improvement Program ◽  
Burn Care ◽  
The Impact ◽  
Complications And Mortality

Abstract Nutrition is a critical component of acute burn care and wound healing. There is no consensus over the appropriate timing of initiating enteral nutrition in geriatric burn patients. This study aimed to assess the impact of early enteral nutrition on outcomes in this patient population. We performed a 1-year (2017) analysis of the American College of Surgeons Trauma Quality Improvement Program and included all older adult (age ≥65 years) isolated thermal burn patients who were admitted for more than 24 hr and received enteral nutrition. Patients were stratified into two groups based on the timing of initiation of feeding: early (≤24 hr) vs late (>24 hr). Multivariate logistic regression was performed to control for potential confounding factors. Outcome measures were hospital and intensive care unit lengths of stay, in-hospital complications, and mortality. A total of 1,004,440 trauma patients were analyzed, of which 324 patients were included (early: 90 vs late: 234). The mean age was 73.9 years and mean TBSA burnt was 31%. Patients in the early enteral nutrition group had significantly lower rates of in-hospital complications and mortality (15.6% vs 26.1%; P = 0.044), and a shorter hospital length of stay (17 [11,23] days vs 20 [14,24] days; P = 0.042) and intensive care unit length of stay (13 [8,15] days vs 17 [9,21] days; P = 0.042). In our regression model of geriatric burn patients, early enteral nutrition was associated with improved outcomes. The cumulative benefits observed may warrant incorporating early enteral nutrition as part of intensive care protocols.

Use of a Nutrition Support Protocol to Increase Enteral Nutrition Delivery in Critically Ill Patients

2014 ◽  
Vol 23 (5) ◽  
pp. 396-403 ◽  
Author(s):  
Friederike Compton ◽  
Christian Bojarski ◽  
Britta Siegmund ◽  
Markus van der Giet
Keyword(s):  
Intensive Care Unit ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Invasive Mechanical Ventilation ◽  
Nutrition Support ◽  
Early Enteral Nutrition ◽  
Feeding Tubes ◽  
Enteral Nutrition Support ◽  
The Impact

BackgroundEarly enteral nutrition is recommended for patients in intensive care units, but nutrition provision is often hindered by a variety of unit-specific problems.ObjectivesTo evaluate the impact of a nutrition support protocol on nutrition prescription and delivery in the intensive care unit.MethodsNutrition-related data from 73 patients receiving mechanical ventilation who were treated in an adult medical intensive care unit before introduction of an enteral nutrition support protocol were retrospectively compared with data for 87 patients admitted after implementation of the protocol.ResultsAfter implementation of the protocol, enteral nutrition was started significantly earlier (P = .007) and enteral feeding goals were reached significantly faster (6 vs 10 days, P < .001) than before. Prescription of enteral nutrition on the first day of invasive mechanical ventilation increased from 38% before to 54% after (P = .03) implementation of the protocol. Prescribed and delivered nutrition doses on the first 2 days of mechanical ventilation also increased significantly (P < .001) after the protocol was implemented. Nasojejunal feeding tubes were used in 52% of patients before and 56% of patients after protocol implementation P = .63). Jejunal tubes were placed earlier after the protocol was implemented than before (median 5 vs 6.5 days), and when a jejunal tube was in place, feeding goals were reached faster (median 2 vs 3 days, P = .002).ConclusionImplementing an enteral nutrition support protocol shortened the time to reach feeding goals. Jejunal feeding tubes were necessary in more than half of the patients, and with a jejunal feeding tube in place, feeding goals were reached rapidly.

Observation of inadvertent tube loss in ICU: effect of nasal bridles

2019 ◽  
Vol 28 (18) ◽  
pp. 1170-1174
Author(s):  
Kaylee Allan ◽  
Stephen Taylor ◽  
Rowan Clemente ◽  
Deirdre Toher
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Service Evaluation ◽  
Early Enteral Nutrition ◽  
Feeding Tubes ◽  
Nasojejunal Feeding ◽  
Review Current

Background: safe placement and securement of feeding tubes are essential to establishing early enteral nutrition. Nasogastric or nasojejunal feeding tubes are often inadvertently removed, and using a nasal bridle can reduce the number of tube replacements required. Aim: to review current nasal bridle practices on one intensive care unit. Over a 3-month period, nasal bridle use was recorded to measure unintentional tube loss and tube duration (the time a tube remained in situ). Method: an observational service evaluation. Findings: 109 patients were recruited; 205 tubes were passed and 77 bridles were inserted, with 42% (n=46) of the bridles placed on day 1. Tubes secured with tape were more likely to be dislodged than tubes secured with a bridle, P=0.0001. Duration of tubes remaining in situ was significantly longer in patients who had a bridle fitted on day 1, P=0.0001 compared with tubes secured with tape. Conclusion: securing a tube with a nasal bridle from day 1 is independently associated with reduced tube loss, increased duration of tube use, and likelihood that the tube would reach redundancy when it was no longer required.

scholarly journals PROGRAM OF INTESTINAL REHABILITATION AND EARLY POSTOPERATIVE ENTERAL NUTRITION: A PROSPECTIVE COHORT STUDY

2018 ◽  
Vol 31 (3) ◽  
Author(s):  
Frank Daniel MARTOS-BENÍTEZ ◽  
Anarelys GUTIÉRREZ-NOYOLA ◽  
Andrés Soto GARCÍA ◽  
Iraida GONZÁLEZ-MARTÍNEZ ◽  
Ilionanys BETANCOUR-PLAZA
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Enteral Nutrition ◽  
Clinical Outcomes ◽  
Gastrointestinal Surgery ◽  
Major Complication ◽  
Nutritional Intervention ◽  
Infectious Complications ◽  
Gastrointestinal Complications ◽  
Intestinal Rehabilitation

ABSTRACT Background: Some factors can act on nutritional status of patients operated for a gastrointestinal cancer. A timely and appropriate nutritional intervention could have a positive effect on postoperative outcomes. Aim: To determine the effect of a program of intestinal rehabilitation and early postoperative enteral nutrition on complications and clinical outcomes of patients underwent gastrointestinal surgery for cancer. Methods: This is a prospective study of 465 patients underwent gastrointestinal surgery for cancer consecutively admitted in an oncological intensive care unit. The program of intestinal rehabilitation and early postoperative enteral nutrition consisted in: 1) general rules, and 2) gastrointestinal rules. Results: The mean age of analysed patients was 63.7±9.1 years. The most frequent operation sites were colon-rectum (44.9%), gynaecological with intestinal suture (15.7%) and oesophagus-gastric (11.0%). Emergency intervention was performed in 12.7% of patients. The program of intestinal rehabilitation and early postoperative enteral nutrition reduced major complication (19.2% vs. 10.2%; p=0.030), respiratory complications (p=0.040), delirium (p=0.032), infectious complications (p=0.047) and gastrointestinal complications (p<0.001), mainly anastomotic leakage (p=0.033). The oncological intensive care unit mortality (p=0.018), length of oncological intensive care unit (p<0.001) and hospital (p<0.001) stay were reduced as well. Conclusions: Implementing a program of intestinal rehabilitation and early postoperative enteral nutrition is associated with reduction in postoperative complications and improvement of clinical outcomes in patients undergoing gastrointestinal surgery for cancer.

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